作者：田蓉1 ，傅桂芬2 ，李丽蓉2 ，石丽梅2 ，李湘2 ，张艳萍2 ，向先才3

单位：

：1.445000湖北省恩施土家族苗族自治州，恩施职业技术学院医学院　2.530021广西壮族自治区南宁市，广 西医学科学院 广西壮族自治区人民医院护理部　 3.445000湖北省恩施土家族苗族自治州，湖北民族大学附属医院 民大 医院甲状腺乳腺外科 小儿外科

Units：

1.Medical School, Enshi Polytechnic, Enshi Tujia and Miao Autonomous Prefecture 445000, China 2.Department of Nursing, Guangxi Academy of Medical Sciences/the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China 3.Thyroid and Breast Surgery·Paediatric Surgery, Affiliated Hospital of Hubei Minzu University/Minda Hospital, Enshi Tujia and Miao Autonomous Prefecture 445000, China

关键词：

糖尿病肾病；老年人；佩普劳人际关系理论；饮食管理

Keywords：

Diabetic nephropathies; Aged; Peplau's interpersonal relationship theory; Diet management

CLC：

R 587.24

DOI：

10.12114/j.issn.1008-5971.2023.00.260

Funds：

广西科技计划项目（桂科AB21220025）；广西中医药大学研究生教育创新计划项目（YCSW2022345）

摘要：

目的　分析基于佩普劳人际关系理论的饮食管理在老年糖尿病肾病（DKD）患者中的应用效果。方 法　选取2021年12月—2022年6月广西壮族自治区人民医院内分泌科收治的老年DKD患者90例为研究对象，按照随机 数字表法将其分为对照组和干预组，各45例。对照组在降糖、控制血压及改善肾功能治疗的基础上，采用常规饮食 管理，干预组在对照组基础上采用基于佩普劳人际关系理论的饮食管理。比较两组一般资料及干预前、干预后2型糖 尿病患者饮食管理量表评分、糖化血红蛋白（HbA1c）、空腹血糖（FBG）、体质指数（BMI）、收缩压（SBP）、患 者对医疗决策参与的满意度量表评分。结果　干预过程中，对照组因病情恶化退出研究1例、失访2例，干预组失访2 例，最终对照组共42例、干预组共43例患者完成本研究。干预组干预后2型糖尿病患者饮食管理量表总分及知识、信 念、行为维度得分高于对照组（P＜0.05）；对照组、干预组干预后2型糖尿病患者饮食管理量表总分及知识、信念、 行为维度得分分别高于本组干预前（P＜0.05）。干预组干预后HbA1c、FBG、BMI、SBP低于对照组（P＜0.05）；对照 组、干预组干预后HbA1c、FBG、BMI、SBP分别低于本组干预前（P＜0.05）。干预组干预后患者对医疗决策参与的满 意度量表评分高于对照组（P＜0.05）；对照组、干预组干预后患者对医疗决策参与的满意度量表评分分别高于本组干 预前（P＜0.05）。结论　基于佩普劳人际关系理论的饮食管理可有效提高老年DKD患者饮食自我管理能力，改善代谢 水平，降低体质量及血压，提高患者对参与医疗决策的满意度。

Abstract：

　Objective To analyse the application effect of diet management based on Peplau's interpersonal relationship theory in elderly patients with diabetic kidney disease (DKD) . Methods A total of 90 elderly DKD patients admitted to the Department of Endocrinology of the People's Hospital of Guangxi Zhuang Autonomous Region from December 2021 to June 2022 were selected as the study objects, and were divided into control group and intervention group according to random number table method, with 45 cases in each group. The control group was treated with routine diet management on the basis of hypoglycemia, blood pressure control and renal function improvement. The intervention group was treated with diet management based on Peiplau's interpersonal relationship theory on the basis of control group. The general data, and Dietary Management Scale for Type 2 Diabetes Patients score, glycosylated hemoglobin (HbA1c) , fasting blood glucose (FBG) , body mass index (BMI) , systolic blood pressure (SBP) and Patient Satisfaction Scale for Medical Decision Participation score before and after intervention were compared between the two groups. Results During the intervention process, 1 patients in the control group withdrew from the study due to deterioration of the disease, 2 cases were lost to follow-up, and 2 cases were lost to follow-up in the intervention group. A total of 42 patients in the control group and 43 patients in the intervention group completed the study. After intervention, the total score of Dietary Management Scale for Type 2 Diabetes Patients and the scores of knowledge, belief and behavior dimensions in the intervention group were higher than those in the control group (P < 0.05) . After intervention, the total score of Dietary Management Scale for Type 2 Diabetes Patients and the scores of knowledge, belief and behavior dimensions in the control group and the intervention group were higher than those before intervention, respectively (P < 0.05) . After intervention, HbA1c, FBG, BMI, and SBP in the intervention group were lower than those in the control group (P < 0.05) . After intervention, HbA1c, FBG, BMI, and SBP in the control group and intervention group were lower than those before intervention, respectively (P < 0.05) . After intervention, the Patient Satisfaction Scale for Medical Decision Participation score in the intervention group was higher than that in the control group (P < 0.05) . After intervention, the Patient Satisfaction Scale for Medical Decision Participation score in the control group and the intervention group was higher than that before intervention, respectively (P < 0.05) . Conclusion Diet management based on Peplau interpersonal relationship theory can effectively improve the diet self-management ability of elderly DKD patients, improve metabolic levels, reduce body mass and blood pressure, and increase patients' satisfaction with participating in medical decision-making.

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